Surgical Outcomes for Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease

Abstract

Surgical resection may provide a survival benefit for patients with NAFLD-related HCC. Patients with NASH-related cirrhosis undergoing major hepatic resection should be treated carefully.

Clinicopathologic Features and Outcomes of Non-B, Non-C Hepatocellular Carcinoma After Hepatectomy

“…1). The percentage of HBV-HCC remained constant (13,14, and 12 %, respectively), but that of HCV-HCC decreased (77, 70, and 60 %, respectively), while NBNC-HCC increased (10, 16, and 28 %, respectively).…”

“…These results are consistent with those of previous studies of NBNC-HCC. [11][12][13][25][26][27] The prognosis of HCC is correlated with the degree of tumor malignancy and the preservation of liver function. 28,29 The finding that patients with NBNC-HCC had more advanced HCC but better-preserved liver function than those with HV-HCC might help to explain the similar prognoses in both these groups.…”

“…8,9 Several studies have examined the outcomes of hepatectomy for NBNC-HCC, some of which have reported a better prognosis for NBNC-HCC patients, while others have reported no differences in survival outcomes between NBNC-HCC and hepatitis virus-positive HCC (HV-HCC). [10][11][12][13] The long-term outcomes of hepatectomy for NBNC-HCC thus remain unclear. Furthermore, few studies have examined the prognostic factors associated with long-term outcomes after hepatectomy in NBNC-HCC patients.…”

Nonalcoholic Fatty Liver Disease (NAFLD) and Hepatocellular Carcinoma: How Common?

“…Another limitation is the potential for reverse causality, by which some of the risk factors (e.g., diabetes or BMI) are affected by the development of HCC or the preceding cirrhosis. Our search found at least 9 studies performed in Asia (n=7 in Japan), 6 in Europe, and 7 in the USA [8,23,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]44•, 45•] (Table 1C). All compared a case group with HCC attributed to NASH/NAFLD or to CC presumptively NAFLD related, with at least 1 control group, typically with HCC attributed to another cause of liver disease (n=19); though 2 had only NASHrelated cirrhosis controls without HCC as their sole comparison or control group.…”

p27 Is a Critical Prognostic Biomarker in Non-Alcoholic Steatohepatitis-Related Hepatocellular Carcinoma

“…Recently, nonalcoholic steatohepatitis (NASH), an advanced type of the obese-related nonalcoholic fatty liver disease (NAFLD), has been recognized as another causative agent of HCC. NASH is a newly identified, non-viral chronic liver disease, which can progress to liver cirrhosis, accompanied by liver failure and HCC, and the prevalence of NASH-related HCC has been increasing in developing countries [1,3,5]. Unfortunately, the precise reason for cancer development in NASH patients has remained enigmatic and clinically useful biomarkers, predicting the risk and the prognosis of NASH-related HCC, have not been discovered to date.…”